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PCOM Anatomy > Shoulder and Arm > Flashcards

Shoulder and Arm Flashcards

1
Q

sternoclavicular joint? ligaments involved?

A
  • connects manubrium of sternum and medial clavicle
  • strengthened by joint capsule and anterior and posterior sternoclavicular ligaments
  • also strengthened by costoclavicular ligaments
  • only bone to bone joint that attaches upper limb to trunk of body
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2
Q

acromioclavicular joint? ligaments involved?

A
  • connects acromion of scapula with the lateral clavicle
  • strengthened by acromioclavicular ligament and coracoclavicular ligament (coracoid and clavicle)
  • coracoclavicular ligament has two parts:
    1. conoid ligament (medial)
    2. trapezoid ligament (lateral)
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3
Q

Shoulder separation? 3 types?

A
  • acromioclavicular joint separation
    1. type 1- no fracture or tear (sprain)
    2. type 2- complete tear of AC ligament
    3. type 3- complete tear of AC and CC ligaments
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4
Q

Glenohumeral joint? capsule?

A
  • glenoid labrum increases depth of cavity
  • head of humerus held in place by rotator cuff muscles
  • capsule:
  • glenoid cavity to anatomical neck of humerus
  • weakest inferiorly
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5
Q

Function of glenoid labrum? common tears?

A
  • fibrocartilage ring
  • deepens glenoid cavity
  • tears common from throwing motion
  • tears most often anterior superior
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6
Q

Ligaments of the glenohumeral joint?

A
  1. coracohumeral ligament
    - coracoid process to greater tubercle
    - strengthens superiorly
  2. transverse humeral ligament
    - greater to lesser tubercle of humerus (bicipital groove)
    - holds long tendon of biceps brachii in place
  3. coracoacromial ligament
    - coracoid process and acromion
    - strengthens joint superiorly
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7
Q

coracoacromial arch?

A
  • coracoacromial ligament
  • abduction:
  • causes impingement of greater tubercle on acromion
  • without rotation the greater tubercle contacts the arch preventing further movement
  • with 180 degrees of lateral rotation complete abduction can occur
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8
Q

shoulder dislocation?

A
  • dislocation of glenohumeral joint
  • head of humerus driven inferior and anterior (95%)
  • treatment:
  • closed or open reduction
  • pull inferiorly and laterally for closed reduction
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9
Q

scapulothoracic joint?

A
  • scapula sits on top of ribs
  • scapula moves:
  • elevation
  • depression
  • protraction
  • retraction
  • rotation (up or down)
  • rotation is important to allow more movement of humerus and to avoid soft tissue damage
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10
Q

Posterior thoracoappendicular muscles?

A
  • trapezius
  • lat dorsi
  • rhomboids
  • levator scapulae
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11
Q

Anterior thoracoappendicular muscles?

A
  • pec major
  • pec minor
  • serratus anterior
  • subclavius
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12
Q

Deltoid attachments?

A
  1. proximal:
    - lateral third of clavicle
    - acromion
    - spine of scapula
  2. distal:
    - deltoid tuberosity
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13
Q

Deltoid innervation?

A

axillary nerve

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14
Q

Deltoid function?

A
  1. clavicular head: flexes and medially rotates arm
  2. acromial head: abducts arm after first 15 degrees to about 90 degrees
  3. spinal head: extends and laterally rotates arm
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15
Q

What are the rotator cuff muscles? functions?

A
  1. muscles (SITS)
    - supraspinatus
    - infraspinatus
    - teres minor
    - subscapularis
  2. functions:
    - form musculotendinous cuff around head of humerus
    - reinforce capsule
    - hold humeral head in glenoid fossa
    - all rotate except supraspinatus (abducts)
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16
Q

Supraspinatus attachments?

A
  1. proximal:
    - supraspinous fossa
  2. distal:
    - greater tubercle of humerus
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17
Q

Supraspinatus innervation?

A

suprascapular nerve

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18
Q

supraspinatus function?

A
  • initiates abduction of arm, first 15 degrees

- person with damage to this muscle leans to one side in order to abduct by gravity and then deltoid kicks in

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19
Q

Infraspinatus attachments?

A
  1. proximal:
    - infrapsinous fossa
  2. distal:
    - greater tubercle of humerus
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20
Q

Infraspinatus nerve?

A

suprascapular nerve

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21
Q

Infraspinatus function?

A
  • laterally rotates arm

- holds head of humerus in glenoid fossa

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22
Q

Teres minor attachments?

A
  1. proximal:
    - lateral border of scapula
  2. distal:
    - greater tubercle of humerus
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23
Q

Teres minor innervation?

A

axillary nerve

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24
Q

Teres minor function?

A
  • laterally rotates arm

- holds head of humerus in glenoid fossa

25
Q

Subscapularis attachments?

A
  1. proximal:
    - subscapular fossa
  2. distal:
    - lesser tubercle of humerus
26
Q

Subscapularis innervation?

A

upper and lower and subscapular nerves

27
Q

Subscapularis function?

A
  • medially rotates and adducts humerus

- holds head of humerus in glenoid cavity

28
Q

Teres major attachments?

A
  1. proximal:
    - inferior angle of scapula
    - lateral border of scapula below teres minor
  2. distal:
    - intertubercular groove of humerus
29
Q

Teres major innervation?

A

lower subscapular nerve

30
Q

Teres major function?

A

-adducts and medially rotates arm

31
Q

Shoulder bursa? functions?

A
  • facilitate movement and prevent damage to muscles as they move upper limb
    1. subacromial/subdeltoid bursa
  • between acromion, coracoacromial ligament and deltoid
  • between supraspinsatus tendon and joint capsule of GH joint
  • movement of supraspinatus under coracoacromial arch
  • movement of deltoid over joint capsule and greater tubercle
    2. subscapular bursa
  • between subscapularis and neck of scapula
  • protects tendon from root of coracoid process and neck of scapula
32
Q

Quadrangular space?

A
  1. boundaries:
    - teres minor
    - teres major
    - humerus
    - long head of triceps brachii
  2. axillary nerve and posterior humeral circumflex artery are located within
33
Q

Blood supply to shoulder?

A
  1. subclavian artery
    - dorsal scapular
    - suprascapular artery (thyrocervical trunk)
  2. axillary
    - subscapular (circumflex scapular)
34
Q

suprascapular artery and nerve? where does it run?

A
  • enters supraspinous fossa through suprascapular notch and runs in supraspinous fossa, around greater scapular notch to infraspinous fossa
  • superior transvers scapular ligament attaches in suprascapular notch to create a tunnel for the nerve to go under bridge, artery goes over bridge
35
Q

Arterial anastomoses around scapula?

A
  • colateral circulation between arteries
  • arteries connect with each other
    1. suprascapular artery
    2. dorsal scapular artery
    3. subscapular artery (circumflex scapular)
  • if blockage, blood can flow around it
36
Q

What do the ulna and radius articulate with on the humerus?

A
  • trochlea with ulna (when flexed, coronoid process of ulna sits in coronoid fossa of humerus)
  • capitulum with radius
37
Q

Purpose of fascia?

A
  1. compartmentalization
    - medial and lateral inter muscular septum (anterior and posterior compartments)
    - organizes nerve and blood supply
  2. provides plane to separate different muscles or nerves from each other
  3. plane for which infection can travel, some prevent infection, some allow them to happen
38
Q

Biceps Brachii attachments?

A
  1. proximal:
    - short head: coracoid process
    - long head: supraglenoid tubercle
  2. distal:
    - radial tuberosity (tendon)
    - fascia of forearm (aponeurosis)
39
Q

biceps brachii innervation?

A

musculocutaneous nerve

40
Q

biceps brachii functions?

A
  • flexion of forearm
  • supination
  • assists in shoulder flexion
41
Q

brachialis attachments?

A
  1. proximal:
    - distal anterior humerus
  2. distal:
    - tuberosity of ulna
42
Q

brachialis innervation?

A

musculocutaneous

43
Q

brachialis function?

A

-primary flexor of forearm

44
Q

coracobrachialis attachments?

A
  1. proximal:
    - coracoid process
  2. distal:
    - middle of humerus
45
Q

coracobrachialis innervation?

A

musculocutaneous nerve

46
Q

coracobrachialis functions?

A

-flex and adduct arm

47
Q

triceps brachii attachments?

A
  1. proximal:
    - long head: infraglenoid tubercle
    - lateral head: humerus superior to radial groove
    - medial head: humerus inferior to radial groove
  2. distal:
    - olecranon process of ulna
48
Q

triceps brachii innervation?

A

radial nerve

49
Q

triceps brachii function?

A

extends forearm

50
Q

Triangular space?

A
  1. boundaries
    - teres major
    - teres minor
    - long head of triceps
  2. content
    - circumflex scapular artery (carries blood to scapular region)
51
Q

Triangular interval?

A
  1. boundaries
    - triceps long head
    - triceps lateral head
    - teres major
  2. content
    - radial nerve
    - profunda brachii artery

-fracture in mid shaft of radius damages radial nerve. spiral groove of radius

52
Q

Anconeus attachments?

A
  1. lateral epicondyle

2. olecranon and posterior ulna

53
Q

Anconeus innervation?

A

radial nerve

54
Q

Anconeus functions?

A
  • extends forearm mainly
  • stabilizes elbow
  • abducts ulna during pronation
55
Q

Brachial artery? boundaries? branches?

A
  1. continuation of axillary artery
  2. inferior border of teres major to cubital fossa
  3. main named branches:
    - deep artery of arm (arteria profunda brachii)
    - superior ulnar collateral
    - inferior ulnar collateral
    - collateral arteries help to create path for blood to flow around elbow joint if obstruction of brachial artery
56
Q

Superficial veins of arm and forearm?

A
  1. cephalic
    - in groove between deltoid and pec major
    - lateral side of forearm
  2. basilic
    - medial side of forearm
  3. median cubital
    - connect the two above
    - in cubital fossa
57
Q

Nerves of the arm?

A
  1. musculocutaneous
    - pierces coracobrachialis
    - innervates muscles of anterior compartment
    - becomes lateral antebrachial cutaneous nerve
  2. ulnar
    - goes behind medial epicondyle to pinky side
    - doesnt innervate anything in arm
  3. median
    - lateral then medial to brachial artery
  4. radial
    - between long and lateral head of triceps
    - radial groove of humerus
    - posterior compartment muscles
58
Q

Fractures of humerus? what is damaged with each?

A
  1. proximal:
    - surgical neck of humerus, most common place
    - axillary nerve
    - posterior humeral circumflex artery
  2. middle:
    - mid shaft involving radial groove
    - radial nerve
    - deep brachial artery
  3. distal
    - moves anteriorly
    - supracondylar
    - median nerve
    - brachial artery
    - ulnar nerve not damaged because it is located posterior

PCOM Anatomy (6 decks)

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